Extension to NAPRA Sterile Compounding Exemption for Palliative Care Patients
CPhM Council has again approved an extension of the exemption for the drawing-up of comfort care medications for Palliative Care patients in a setting that does not meet the NAPRA Model Standards for Sterile Compounding. Council will review the exemption again prior to the new expiry date of January 1, 2024. Any pharmacy or pharmacist that is considering the utilization of this exemption must be knowledgeable and fully compliant with the following requirements:
When deciding if the service should be provided:
- The patient must be registered with the palliative care program.
- The medications should be non-hazardous, and the manipulation be low risk (as defined by NAPRA) and prepared from a commercially available sterile source only.
- The preparation should be only a single manipulation (i.e., pre-filling a syringe).
- All possibilities of training a caregiver or family member to draw up medication should be exhausted first before contemplating this option.
- The physician determines that this is the only viable method of effective treatment of the patient and the prescription indicates “for emergency use.”
- The benefit vs. risk favours rapid access to the medication.
Once the decision has been made to provide the service:
- The patient or agent must sign a waiver/release form to acknowledge the preparation is from a non-compliant facility “for emergency use only”.
- The product should be monitored for signs of potential contamination at draw-up, and further education should be provided to the patient’s agent to monitor before administration.
- Preparation should take place in a designated compounding area following the standards for preparing immediate use preparations (see NAPRA Model Standards for Sterile Compounding).
- The compounder must don minimum personal protective equipment (PPE), including but not limited to sterile gloves (or gloves that have been disinfected with sterile alcohol) and a medical grade mask.
- The preparation must be performed by a pharmacist or regulated pharmacy technician.
- The preparation is limited to a two day supply that must be labelled with a maximum beyond use date of 48 hours from the point of preparation.
- The non-compliant pharmacy is limited to supplying a maximum of 6 days (three occurrences under this exemption).
- Supply of medications beyond the limits must occur from a NAPRA compliant facility. The pharmacy must refer the patient to a compliant facility or obtain medications prepared from a compliant facility.
- The product must be stored appropriately at the pharmacy, and education must be provided to the patient’s agent on storage at home.
Prior to consideration of using the above exemption, it is imperative that pharmacists make every effort to seek the services of, or refer a patient to, a pharmacy that can provide sterile compounding that fully meets the NAPRA Model Standards for Sterile Compounding. This is considered ideal, best practice, and in the best interest of patient safety. The exemption is intended to provide timely access to necessary medications in order to offer the pharmacist and patient/caregiver time to source out fully compliant sources of the drug product.
Call for Committee Members – Pharmacy Technician Regulatory Issues Ad-Hoc Committee
The College of Pharmacists of Manitoba (CPhM) is seeking pharmacy technicians to serve on the Pharmacy Technician Regulatory Issues Ad-Hoc Committee. Pharmacists, pharmacy students, and pharmacy interns are welcome to join.
As a committee member, you would help identify the enablers and barriers to pharmacy technician regulation and practice in Manitoba and make recommendations to Council. Maintaining patient safety and improving patient outcomes will be key considerations for the Committee. More information about the Committee can be found in the Pharmacy Technician Regulatory Issues Ad-Hoc Committee Terms of Reference.
To express your interest, please review the information on Committee Service and submit a Committee Expression of Interest Form to firstname.lastname@example.org.
Consultation for Feedback on the Rural, Remote and Underserved Populations: Access to Prescribed Medications Joint Practice Statement
Rural, remote, and underserviced populations are at risk for potentially harmful delays in care because of barriers to timely access to services. Taking this into account, Manitoba’s Nursing Colleges, the College of Physicians and Surgeons of Manitoba and the College of Pharmacists of Manitoba (CPhM) collaborated to create a joint practice statement entitled Rural, Remote and Underserved Populations: Access to Prescribed Medications (the joint practice statement). The joint practice statement was approved in April 2018 and is currently in effect.
CPhM is launching a consultation on the joint practice statement to gather feedback on its use in pharmacy practice. Pharmacy professionals who provide care to rural, remote and underserviced populations are encouraged to participate in the consultation.
The consultation deadline has been extended to December 30, 2022, and can be accessed via the following link https://www.surveymonkey.com/r/6KST5MD.
Call for Interviewees – Perspectives on the Vaccine Distribution Strategy for COVID-19 in Manitoba, University of Manitoba Study
The College of Pharmacists of Manitoba is distributing the following information on behalf of Dr. Aggarwal from the University of Toronto and Dr. Katz from the University of Manitoba regarding a study entitled, Vaccine Distribution Approaches for Underserved and At-Risk Populations during COVID-19: Best Practices and Lessons Learned in Canada.
Dr. Aggarwal and her colleagues are looking to interview individuals that can provide perspectives on the vaccine distribution strategy for COVID-19 in Manitoba. Participants in this study will be asked about their thoughts and experiences with vaccine distribution approaches within their jurisdictions, the strengths, weaknesses, and limitations of various approaches, the factors that influenced the uptake of vaccine distribution approaches by the public, and lessons learned. Further information on the purpose of the research study and participation in the study can be found in the following information letter: https://cphm.ca/wp-content/uploads/Temporary-Attachments/Information-Letter-and-Consent-Form-for-Key-Informant-Interviews.pdf.
If you have any questions about the study, please contact Carolynn Warnet, Research Coordinator at the University of Toronto, by email at email@example.com.
Call for Award Nominations
The College of Pharmacists of Manitoba (CPhM) is now accepting nominations for the 2022 CPhM Awards. If you or a pharmacist you know has made a noteworthy contribution to patient care and safety or the practice of pharmacy, please consider submitting a nomination or application for one of the awards listed in the CPhM Awards Brochure.
CPhM has created award submission guidelines for your consideration prior to forwarding your nomination to the Awards & Nominating Committee.
Young Leader Awards
The Young Leader Awards celebrate the efforts of up to ten leaders in pharmacy practice. The recipients will receive a plaque to commemorate their contributions to the pharmacy profession and a $500 cash prize.
The awards are open to recently licensed pharmacists (practicing one to five years post-graduation) and to pharmacy students (interns) in their final year of study who have made a professional contribution to patient care, the pharmacy profession or amongst their colleagues and peers at the University of Manitoba’s College of Pharmacy.
If you or someone you know meet these criteria, please submit a nomination or application package including the nominee or applicant’s Curriculum Vitae and a summary of their activities and contributions within pharmacy practice or within the University of Manitoba’s College of Pharmacy.
The deadline for nominations or applications is Friday, January 13, 2023. Please send submissions by email to firstname.lastname@example.org with the subject line “Attention: The Awards & Nominating Committee – CPhM Awards”
CPhM Office Schedule During Holiday Season
The College of Pharmacists of Manitoba will observe the following holiday schedule:
- Closed Monday, December 26, 2022, through Monday, January 2, 2023.
- Regular office hours resume on Tuesday, January 3, 2023, from 8:30 a.m. to 4:30 p.m.
Please be reminded that CPhM has pandemic-response protocols in place. All CPhM services continue, however adjustments in service delivery or delays may occur. Please call ahead before visiting the CPhM office to ensure staff are available to help you.
Documents may be left in the black deposit box to the left of the main entrance. Email is the most efficient means by which to contact staff. Thank you for your kind attention and cooperation.